advice please

[Numptybrain]

Hi, I’m struggling with bilateral pleural effusion and pericarditis, had the pleural effusion for over a year but the pericarditis was come and go, now it’s permanent, I have osteoarthritis and osteoporosis and a long history of pain etc. my respiratory consultants are all saying inflammation is to blame for the effusion and pericarditis and blaming a connective tissue disease but rheumi won’t except lupus sle or RA as I have no swollen joints although I have pain, my eyes and mouth are constantly dry . He is now testing me for PMR and put me on steroids for a month tapering off then wants another CT scan of my lungs to see if inflammation has lowered, I thought he was quite rude and in a hurry to leave as I was last patient if the day and he didn’t even look at the photos in my phone my daughter was trying to show him of skin rashes and swollen knuckles. Has anyone had involvement of pleura and pericarditis please?

[PMRpro Ambassador]

It isn't something I have come across in all the years I have been on forums for PMR.

You can't "test" for PMR - just the raised inflammatory markers and I imagine they will be raised anyway. Have you had Covid? Or did it start after a Covid vaccination? German researchers from Charite in Berlin found that the pericarditis it can cause is not only found in young men as was thought at first but is also seen in older adults (over 50).

ncbi.nlm.nih.gov/pmc/articl...

[Numptybrain in reply to PMRpro]

No not after Covid I’m 61

Thanks

[SnazzyD]

It’s horrible to be disregarded. On what grounds has the rheumatologist ruled out lupus?

[Numptybrain in reply to SnazzyD]

I didn’t have swelling or heat even though I have had but it wasn’t present at the time he said it would be present permanently.

[piglette]

Have you had blood tests? For example CRP, ESR and ANA?

[Numptybrain in reply to piglette]

Ana negative the rest raised

[fmkkm]

I had a friend with Sjogren’s with similar symptoms, awfully hard to diagnose though.

[PMRpro Ambassador in reply to fmkkm]

There are 2 conditions with almost identical symptoms: Sjoegrens and sicca syndrome. The difference is that Sjoegrens patients have antibodies in their blood, sicca syndrome ones don't.

[Numptybrain]

so you think it’s more sjogrens?

[PMRpro Ambassador in reply to Numptybrain]

Who are you asking? If you ask a a question to someone specific it helps if you use the Reply box in the post by that person then it is directed to them, not the general forum.

[Numptybrain in reply to PMRpro]

Sorry, you

[PMRpro Ambassador in reply to Numptybrain]

I was just explaining the difference - Sjoegrens itself isn't that difficult to confirm since if the antibody is present, it is Sjoegrens. However, many autoimmune disorders are accompanied by sicca syndrome where the main problem is dryness which can manifest in any region of the body: eyes, mouth, vagina in women. There isn;t a cure for either so it is a moot point as to whether accruate diagnosis is essential - you manage the symptoms.

[Numptybrain in reply to PMRpro]

I’ve thought about sjogrens but there doesn’t seem to be any link with pleural effusion’s and pericarditis and that’s my main issue at the moment. I’ve had joint and muscle also respiratory involvement since my late teens when I first developed pneumonia then brittle asthma now I have osteoporosis at 60 I’ve had spinal fractures and rib fractures a subarachnoid haemorrhage ( no cause found) bilateral sensorial hearing loss memory and cognitive issues etc and I’ve had double pneumonia and sepsis twice in two years and now have a kleb infection in my lungs since December which I’ve had 4th lot of antibiotics for my lung Ct scans showing inflammation. The effusion and pericarditis has been going on for over a year and respiratory and all saying connective tissue disease but rheumatologist who I’ve only seen twice and was quite rushed and rude second time only took interest when he realised I’d had fractures and I have osteoporosis yet the reports have been there for him to see and he was at an MDT meeting about me.

[PMRpro Ambassador in reply to Numptybrain]

Time to seek a different and better rheumy. No doctor who was rude to me and didn't apologise at an early opportunity would get another chance from me. Whoever he thinks he is, top dog or whatever, self-praise is no recommendation.

[Numptybrain in reply to PMRpro]

My respiratory team did say if they don’t get any diagnosis from him they are getting me a second opinion.